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dermatology > blistering skin disorder / miscellaneous skin disorders > Flashcards

blistering skin disorder / miscellaneous skin disorders Flashcards

1
Q

blistering skin disorders - types

A
  1. pemphigus vulgaris
  2. Bullous pemphigoid
  3. dermatitis herpetiformis
  4. Erythema multiforme
  5. Steven-Johnson syndrome
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2
Q

pemphigus vulgaris - mechanism

A

autoimmune skin disorder with IgG antibody against desmoglein (component of desmosomes) (stratum spinosum)

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3
Q

pemphigus vulgaris - appearance

A

Flaccid intraepidermal bullae caused by acantholysis

ORAL MUCOSA ALSO INVOLVED

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4
Q

pemphigus vulgaris - immunofluorescence

A

antibodies around epidermal cells in a reticular (net like) pattern

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5
Q

pemphigus vulgaris - sign

A

Nikolsky sign +

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6
Q

Nikolsky sign +

A

separation of epidermis upon manual stroking of skin

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7
Q

pemphigus vulgaris - course

A

potentially fatal

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8
Q

bullous pemphigoid - mechanism

A

IgG antibody against hemidesmosomes (epidermal basement mambrane)

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9
Q

bullous pemphigoid - Nikolsky sign

A

negative

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10
Q

bullous pemphigoid - immunofluorescence

A

linear pattern at epidermal-dermal junction

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11
Q

bullous pemphigoid - appearance

A

tense bilsters (CONTAINING EOSINOPHILS) affect skin but spares oral mucosa

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12
Q

dermatitis herpetiformis - appearance

A

pruritic papules, vesicles and bullae (often found on elbows)

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13
Q

dermatitis herpetiformis - pruritic papules, vesicles and bullae are often found on

A

elbows

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14
Q

dermatitis herpetiformis - associated with

A

celiac disease

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15
Q

dermatitis herpetiformis - mechanism

A

deposits of IgA at tips of dermal papillae (associated with celiac disease)

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16
Q

pemphigus vulgaris vs bullous pemphigoid - according course

A

pemphigus vulgaris –> potentially fatal

bullous pemphigoid –> less severe

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17
Q

pemphigus vulgaris vs bullous pemphigoid - according mechanism

A

pemphigus vulgaris –> IgG against desmoglein

bullous pemphigoid –> IgG against hemidesmosomes

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18
Q

pemphigus vulgaris vs bullous pemphigoid - Nikolsky sign

A

pemphigus vulgaris –> +

bullous pemphigoid –> -

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19
Q

pemphigus vulgaris vs bullous pemphigoid - immunofluorescense

A

pemphigus vulgaris –> reticular (net like)

bullous pemphigoid –> linear pattern

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20
Q

Erythema multiforme is associated with

A
  1. infection 2. drugs 3. cancers 4. autoimmune diseases
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21
Q

Erythema multiforme - infections?

A
  1. Mycoplasma pneumoniae

2. HSV

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22
Q

Erythema multiforme - drugs?

A
  1. sulfa drugs
  2. β-lactams
  3. phenyntoin
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23
Q

Erythema multiforme - presents with

A

multiple types of lesions - macules, papules, vesicles, target lesions

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24
Q

Erythema multiforme - target lesions?

A

look like targets with multiple rings and dusky center showing epithelial disruption

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25
Steven - Johnson syndrome is symptoms
1. fever 2. bullae formation 3. necrosis | 4. sloughing of skin 5. targetoid lesions may appear
26
Steven - Johnson syndrome - prognosis
high mortality rate
27
Steven - Johnson syndrome - skin manifestations
1. bullae formation 2. necrosis | 3. sloughing of skin 4. targetoid lesions may appear
28
Steven - Johnson syndrome - typically involves
2 mucous membranes
29
Steven - Johnson syndrome -targetoid skin lesions may appear, as seen in
erythema multiforme
30
Steven - Johnson syndrome is usually associated with (is a result of)
adverse drug reaction
31
more severe form of Steven - Johnson syndrome
toxic epidermal necrolysis
32
toxic epidermal necrolysis - characteristic
more severe form of Steven - Johnson syndrome | >30% of the body surface
33
Steven - Johnson syndrome with >30% of the body surface
toxic epidermal necrolysis
34
Steven - Johnson syndrome with 10%-30% of the body surface
Steven - Johnson syndrome-toxic epidermal necrolysis
35
Acanthosis nigricans are associated with
1. hyperinsulinemia (diabetes, obesity, cushing) | 2. visceral malignancy (eg, gastric adenocarcinoma)
36
Acanthosis nigricans - mechanism
epidermal hyperplasia causing, SYMMETRIC, hyperpigmented thickening of skin, esp in axilla or neck
37
Acanthosis nigricans - MC areas
axilla | neck
38
Acanthosis nigricans - skin manifestations
symmetric, hyperpigmented thickening of skin, especially in axilla or on neck
39
Squamous cells carcinoma (SCC) of the skin - precursor lesion
Actinic keratosis
40
Actinic keratosis - risk of SCC is proportional to
degree of epithelial dysplasia
41
Actinic keratosis is caused by
sun exposure
42
Actinic keratosis appearance
scaly plaque, hyperkeratotic | small, rough, erythematous or brownish papules or plaques
43
Erythema nodosum are .. (and histological area)
painful inflammatory lesions of subcutaneous fat
44
Erythema nodosum - MC area of the body
anterior shins
45
causes of Erythema nodosum
1. idiopathic 2. sarcoidosis 3. coccidioidomycosis 4. histoplasmosis 5. TB 6. streptococcal infections 7. leprosy 7. Inflammatory bowel disease
46
Sunburn?
acute cutaneous inflammatory reaction due to excessive UV irradiation
47
Sunburn is due to
excessive UV irradiation
48
Sunburn causes (pathophysiology)
DNA mutations --> apoptosis of keratinocytes
49
Ultraviolet A is dominant in
tanning (skin color is darkened) and photoaging (premature aging of the skin due to chronic exposure of skin to ultraviolet)
50
Ultraviolet B is dominant in
sunburn
51
Ultraviolet A and B - nm?
A: 400-320 nm B: 320-290 nm
52
sunburn can lead to
1. impetigo | 2. skin cancers
53
pityriasis rosea - skin manifestations
Herald patch followed days later by other scaly erythematous plaques, often in a Christmas tree distributions Multiple plaques with collarette scale
54
pityriasis rosea - treatment
self-resolving in 6-8 weeks
55
tense blisters containing eosinophils - skin disorder
bullous pemphigoid
56
skin disorder associated with IgA deposition at tips of dermal papillae
dermatitis herpetiformis
57
skin disorder associated with celiac disease
dermatitis herpetiformis
58
pemphigus vulgaris is caused by
acantholysis
59
Lichen planus - skin manifestation
mneominc 6Ps 1. Pruritic 2. Purple 3. Polygonal Planar Papules 4. Plaques
60
Liches Planus is associated with
hepatis C
61
hepatis C - skin disease associated
Liches Planus
62
Liches Planus - histology
Sawtooth infiltrate of lymphocytes at dermal - epidermal junction
63
Liches Planus - mucosa involvement as
Wickham striae (reticular white lines)
64
Wickham striae appearance
reticular white lines
65
sulfa drugs - skin disease?
erythema multiform
66
dermatitis herpetiformis - treatment
1. gluten free diet | 2. dapsone
67
tense blisters of bullous pemphigoid contain
eosinophils

dermatology (9 decks)

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